To study the clinicopathologic characteristics,immunohistochemical features,differential diagnosis,and prognosis of solitary fibrous tumours(SFT)/hemangiopericytomas(HPC)in the maters(meninx). Methods A series of 7 cases previously diagnosed as SFT/HPC at the Department of Pathology,Peking Union Medical College Hospital,during the period from 2008 to 2018 were analyzed for clinical data,histopathology,and immunohistochemical findings.The patients were followed up and the relevant literatures were reviewed. Results These seven patients included two males and 5 females aged 22 to 77 years(mean,49 years).Headache was the most common symptom.The magnetic resonance imaging of SFT/HPC showed irregularly contoured masses and dural tail sign was observed at the periphery of the lesion in 4 cases.The major axis of the tumor ranged from 1.8 cm to 10 cm(mean,4 cm).The tumors were located in the mater in 6 cases and in the spinal meninx in 1 case.The tumors were surgically removed in all cases.Under light microscope,the tumors were formed by long round,oval or spindle cells,with rich branching vascular pattern and varying quantity of collagenous fibers bands in both sparse areas and dense areas.According the WHO classification,2 cases were in WHO grade Ⅰ,2 cases in WHO grade Ⅱ,and 3 cases in WHO grade Ⅲ.Immunohistochemistry of the paraffin-embedded tissues in all cases showed positive immunoreativity for CD34 and vimentin in all seven cases,along with positive signal transducer and activator of transcription 6 in 4 cases,negative epithelial membrane antigen and S-100 in 7 cases,and negative progestational hormone and somatostatin receptor 2 in 6 cases.The Ki-67 index ranged from 1% to 15%.Five patients with follow-up data(including 1 current case)were alive,while 2 patients were lost to follow-up. Conclusions The SFT/HPC are rare in the maters(meninx)and is clinically difficult to be differentiated from other meningioma.The combination of CD34 and signal transducer and activator of transcription 6 helps to diagnose this disease.
Adult ; Aged ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Hemangiopericytoma ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Male ; Meninges ; pathology ; Middle Aged ; Prognosis ; STAT6 Transcription Factor ; metabolism ; Solitary Fibrous Tumors ; diagnosis ; pathology ; Young Adult

In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.
Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pelvis ; pathology ; Retrospective Studies ; Solitary Fibrous Tumors ; diagnosis ; pathology ; Tomography, X-Ray Computed

Humans ; Nasal Cavity ; pathology ; Nose Neoplasms ; diagnosis ; Paranasal Sinuses ; Solitary Fibrous Tumors ; diagnosis

OBJECTIVE: To determine the CT imaging features for retroperitoneal solitary fibrous tumor (SFT).
 METHODS: The imaging features of CT for 2 SFT cases, confirmed by pathological examination, were retrospectively analyzed and compared with pathological results.
 RESULTS: The results of CT showed that retroperitoneal SFTs were large, well-defined and consisted of solid components with different density (equal or low). In the scan of contrast enhancement, tumors were strongly enhanced, and the multiple vascular shadows were seen in the tumor at arterial phase. There was progressive enhancement from the arterial to venous phase, and capsule of tumor was displayed. Histologically, the tumors were composed of spindle cells within a background of collagen stroma, and showed a wide range of growth patterns, alternating hypercellular (tumor cell-rich) and hypocellular (collagen-rich) areas. The diagnosis was confirmed by positive immunohistochemical staining for CD34 and bcl-2.
 CONCLUSION The retroperitoneal SFT possesses a definite characteristic in CT imaging features, and the diagnosis can be confirmed by histopathology and immunohistochemistry.
Humans ; Hyperplasia ; Immunohistochemistry ; Retroperitoneal Space ; pathology ; Retrospective Studies ; Solitary Fibrous Tumors ; diagnosis ; Tomography, X-Ray Computed

Adult ; Angiomyolipoma ; pathology ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Hemangiopericytoma ; pathology ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Nephrectomy ; Sarcoma, Synovial ; pathology ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo elaborate on the clinical and pathologic features of sarcomatoid malignant mesothelioma (SMM), its diagnostic criteria and differential diagnoses.

METHODSTwenty-two cases of SMM retrieved from in-house and consultation files (between January 2009 to September 2013) were reviewed with emphasis on the clinicopathologic characteristics, immunophenotypes and the prognostic impact.

RESULTSThe mean age of the patients was 54 years (ranged from 24-73 years). There was no sexual predilection and the majority of the patients did not have history of asbestos exposure. Overall, 14 tumors developed in the pleura and 8 cases arose from the peritoneal cavity. Clinically, patients presented signs and symptoms in accord with the location of the tumors, notably coughing, shortness of breath, and chest pain for patients with pleural origin, and nausea, abdominal distention and abdominal pain for those with peritoneal primary. In most cases, CT and MRI scan demonstrated lobulated masses (8/11). However, diffuse infiltrative growth patterns were observed exclusively in a minority of pleural cases (3/11). No visceral lesion was observed in any case. Histologically, 19 cases had either fibrosarcomatous or undifferentiated pleomorphic sarcoma-like appearance. Two cases were consistent with desmoplastic mesothelioma. One case contained osteosarcomatous element. All cases expressed pan-cytokeratin (AE1/AE3), and most cases were also positive for D2-40 (15/20). The staining of calretinin (9/21) and WT1 (10/14) was generally weak and focal. They were all negative for TTF-1, napsin A, SP-A, p63 and CD34. Follow-up information (range from 1 to 36 months) was available in 11 cases, 6 of which were alive with unresectable tumor, 1 patient with recurrent disease and 4 patients succumbed to disease. The overall survival was 5 months (mean 8 months).

CONCLUSIONSThe diagnosis of SMM is achieved by comprehensive evaluation of medical history, imageological and pathological findings. Since calretinin immunoreactivity is infrequently observed in SMM, application of pan-cytokeratin and D2-40 immunostains offers a reasonable alternative for diagnosis. Diagnosis of SMM can be made by excluding a variety of spindle cell neoplasms with overlapping features, such as sarcomatoid carcinoma, synovial sarcoma, solitary fibrous tumor and fibrous pleuritis.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma ; diagnosis ; pathology ; Diagnosis, Differential ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Mesothelioma ; diagnosis ; pathology ; Middle Aged ; Prognosis ; Sarcoma ; diagnosis ; pathology ; Solitary Fibrous Tumors ; diagnosis ; pathology

Solitary fibrous tumors (SFTs) are an uncommon neoplasm characterized by the proliferation of spindle cells. The diagnostic criteria of malignant solitary fibrous tumors (MSFTs) include high cellularity, high mitotic activity (4>10 HPF), pleomorphism, hemorrhage and necrosis. This tumor frequently involves the pleura and MSFTs of retroperitoneum mimicking gastric submucosal tumor are very rare. We report a rare case of MSFT that presented as a gastric submucosal tumor. A gastroscopic examination showed a large bulging mucosa in the gastric body. Abdominal computed tomography revealed a well-defined heterogeneous enhancing mass between the left hepatic lobe and gastric body. Surgical resection was performed and histologic features were consistent with a MSFT.
Antigens, CD34/metabolism ; Gastroscopy ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery ; Solitary Fibrous Tumors/*diagnosis/pathology/surgery ; Stomach Neoplasms/diagnosis ; Tomography, X-Ray Computed

Adult ; Aged ; Antigens, CD34 ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangiopericytoma ; metabolism ; pathology ; radiotherapy ; surgery ; Humans ; Male ; Meningeal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Meningioma ; metabolism ; pathology ; Middle Aged ; Neoplasm Recurrence, Local ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Solitary Fibrous Tumors ; metabolism ; pathology ; Vimentin ; metabolism ; Young Adult

Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Sigmoid Neoplasms ; diagnosis ; pathology ; surgery ; Solitary Fibrous Tumors ; diagnosis ; pathology ; surgery

Diagnosis, Differential ; Endometrial Stromal Tumors ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Leiomyoma ; metabolism ; pathology ; Middle Aged ; Neprilysin ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Rectal Neoplasms ; metabolism ; pathology ; surgery ; Rectum ; surgery ; Solitary Fibrous Tumors ; metabolism ; pathology